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Objective:   Recent case reports suggest a link between reduced melanocortinergic tone and both obesity and attention deficit / hyperactivity disorder (ADHD). We present the case of a 13-year-old, male, obese  MC4R  mutation carrier with ADHD.   Case Report:   The boy carries a heterozygous mutation in the  melanocortin 4 receptor  gene ( MC4R;  Met281Val), that leads to a reduced receptor function. Dominant mutations of this type represent major gene effects for obesity. He participated in a lifestyle intervention program for obesity and received treatment with the selective norepinephrine re-uptake inhibitor atomoxetine for 31 months. The boy markedly reduced his BMI from 47.2 to 29.6 kg/m².   Conclusion:   Atomoxetine proved to efficiently reduce weight in a severely obese  MC4R  mutation carrier with ADHD. We briefly discuss possible mechanisms for our observation, including evidence for the functional connectivity between melanocortinergic, dopaminergic, and norepinephrinergic brain circuitries.

obesity facts

Successful Treatment with Atomoxetine of an Adolescent Boy with Attention Deficit/Hyperactivity Disorder, Extreme Obesity, and Reduced Melanocortin 4 Receptor Function